DOCSLIB.ORG

Prevalence and Determinants of Dental Caries Experience Among Adolescents in Kazakhstan: a Cross-Sectional Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Prevalence and Determinants of Dental Caries Experience Among Adolescents in Kazakhstan: a Cross-Sectional Study Prevalence and determinants of dental caries experience among adolescents in Kazakhstan: a cross-sectional study Anara Zhumadilova ( [email protected] ) Nazarbayev University https://orcid.org/0000-0001-7514-9705 Turgan Supiyev Kazakh Medical University Continuing Education Sholpan Abralina Semey Medical University Ardak Yeslyamgaliyeva Astana medical university Aizhan Kulmirzayeva Astana medical university Adil Supiyev Nazarbayev University National Laboratory Astana Research article Keywords: DMF, Adolescents, caries prevalence, socioeconomic determinants, dental health, Central Asia, Kazakhstan. Posted Date: May 10th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-25373/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Version of Record: A version of this preprint was published on February 15th, 2021. See the published version at https://doi.org/10.37290/ctnr2641-452X.19:388–397. Page 1/19 Abstract Background The information on dental caries experience and its determinants in Central Asia is limited. The aim of the present study was to provide estimates of the mean levels, prevalence and severity of dental caries, and to identify the factors associated with these characteristics in the population of school-aged children from four regions in Kazakhstan. Methods We examined 2149 schoolchildren aged 11–15 years from 4 regions of Kazakhstan. The overall response rate was 68%. Dental caries experience was assessed clinically, and standardized questionnaire was used to gather sociodemographic and oral health behavior information. Caries experience was measured by using DMFT (decayed, missing, and lled teeth) index. Negative binomial hurdle regression model was used to assess the relationship between the caries experience and covariates. Results The overall prevalence of dental caries was 74%, obvious decayed teeth was found in 44% of subjects, while only 6% had missing teeth and 24% had their teeth treated. The mean DMFT index was 2.48 among 12-year-olds and 3.9 among 15- year-olds. There were large differences of dental caries experience between the regions, with all indicators (decayed, missed and lled teeth) being less favourable in Semey region. The caries prevalence experience in the studied population was associated with higher age, geographic region, ethnicity, mother’s education, material deprivation, frequent consumption of sugar-added drinks, age of start brushing the teeth and dental attendance pattern. Age, region, ethnicity, dietary habits and dental attendance pattern were found to be signicantly associated with the predicted degree of caries experience among those with caries experience. Conclusions The high prevalence of dental caries and large differences in caries indices between the regions in Kazakhstan might be related to rapid westernization in the Central Asian region and associated nutrition transition. Also, the increasing burden of untreated caries in less advantaged populations was observed. Parent education and material deprivation may be a very important determinants of the oral health among adolescents in Kazakhstan. Background Caries is preventable condition, but still remains the most prevalent among the dental diseases (1, 2) resulting in expensive treatments and other negative consequences affecting the overall health (3). World Health Organization (WHO) stated that dental caries is pandemic mostly affecting schoolchildren with very high prevalence up to 90% (2, 3). Dental caries is a multifactorial disease, various factors contributing to tooth decay development in children was found at individual level, including oral health behaviours and dietary habits, (4, 5) as well as numerous studies demonstrated strong association of dental caries experience with socioeconomic markers. (6, 7). Many of these risk factors might be related to societal changes after the collapse of the Soviet Union, when the newly independent states faced a rapid nutrition transition shifting towards westernized diets and increased consumption of sugar-added drinks and foods (8–10). The implications of these rapidly changing behaviours is not only the high prevalence, but also more severe dental caries experience (5, 11). According to the WHO oral health surveillance databank (12) Kazakhstan had one of the highest DMFT index among 12-year-olds equal to 4.0 (2015), while neighbouring Russia had 2.5 (2008) and China had 0.9 (2015); in turn the DMFT index in some developed countries was as low as 0.5 in UK and 0.7 in Sweden (2017). This routine information in other Central Asian countries was not available. Providing the evidence on the rates of caries experience and associated factors are very important, since modifying these risk factors may provide great potential to prevent the disease in Central Asian region and elsewhere (13–16). Despite the high prevalence of dental caries and the importance of oral health for the quality of live, aesthetics and treatment cost issues, there are very few reliable individual-level data on this condition in the Central Asian countries (6, 17).The best available information on dental caries in this region were either outdated (18, 19), or the methodology of clinical examination and statistical analysis of the results was unclear (20). Importantly, given the positively skewed distribution of DMFT scoring and a large number of zero values the appropriate statistical analyses should be considered for correct interpretation and understanding of caries risk factors (5, 11, 20). The aim of the present study was to provide estimates of the mean levels, Page 2/19 prevalence and severity of dental caries, and to identify the factors associated with these characteristics in the population of school-aged children from four regions in Kazakhstan. Methods Kazakhstan Adolescent Health Study The dataset used for this study is the Kazakhstan Adolescent Health Study (KAHS) implemented by the Laboratory of Epidemiology and Public health at the National Laboratory Astana in Nazarbayev University in collaboration with University College London, UK. The study was mainly based on the protocol of the Health Behaviour in School-Aged Children study (HBSC) (21), a WHO Collaborative Cross-National study, covering 44 countries and focusing on understanding adolescents’ health in social context, the protocol was taken from the HBSC study after agreement with HBSC steering committee. For the dental health part of the KAHS study the Children’s Dental Health Survey (CDHS) protocol was adapted and included both, the questionnaires for schoolchildren and their parents (22, 23). Study population The data for this cross-sectional survey were collected between 2014 and 2015. The target population was children between 11 and 15 years of age residing in the ve regions of Kazakhstan: Nur-Sultan (capital city) and Kokshetau (North of Kazakhstan), Oskemen (East of Kazakhstan), Semey (East of Kazakhstan) and Qaragandy. Qaragandy was not included in the current analysis as it did not have the data on dental examination. Two schools of two different types were selected in each region. One type of school was Nazarbayev Intellectual School (NIS), a special type of school owned by the government, but with a distinct private structure, designed specically for talented students. The second type of school was a regular public school, which serves the general population in each region. Both types of schools do not require any entry fees and are free of charge throughout the whole period of education. Access to the parents of the adolescents in the target age group was achieved through parents-teacher meetings specially organized at each participating school. Parents were provided with oral and written information about the study prior being asked to consent for their child taking part in the study. Structured questionnaires contained sections on socio-demographic, socioeconomic, health, behavioural, and environmental information. Objective measurements were taken by trained staff and health professionals and included height, weight, waist and hip circumferences, blood pressure measurements, spirometry, swabs of buccal epithelium, hair samples and comprehensive dental health examination. In total, 2149 adolescents aged 11– 15 years participated in the study. The overall response rate was 68%. Clinical Examination Clinical examination was carried out by 8 calibrated dentists in total, two in each participated region. Familiar adult, such as a school nurse or a teacher were present during the oral examination. All children were explained prior to examination about process of dental observation to reduce the anxiety. Each intra-oral clinical examination was performed with the child seated in a conventional school chair facing a window with sunlight access under standard conventional light with the dentist wearing a headlight. The examination was carried out using a sterilized, disposable set consisting of an illuminated mouth mirror and a blunt ball-ended probe with an end diameter of 0.5 mm (24). The assessments were performed only on cooperative basis to ensure the wellbeing of the children after parental approval. The dentist recorded the ndings for each child on the scoring sheet. Dental caries denition In our study the dental caries experience was measured by the number of decayed (into dentine), missing, and lled teeth (DMFT), where the maximum score of DMFT could be up to 28 (wisdom teeth were excluded due to uneruption) and the minimum score equal zero. The diagnostic
Load more

Recommended publications
  • Report No. PID10560
    Report No. PID10560 Project Name KAZAKHSTAN-Northeastern Kazakhstan Water Supply and (@) Sanitation Project Region Europe and Central Asia Region Sector Water supply (50%); General water/sanitation/flood protection sector (25%); Sub-national government Public Disclosure Authorized administration (25%) Project ID P070008 Borrower(s) GOVERNMENT OF KAZAKHSTAN Implementing Agency Address PARTICIPATING WATER UTILITIES Water and wastewater enterprises (vodokanals) of the cities of Karaganda (JSC Vodokanal), Temirtau (Nizhny Bief Ltd.) and Kokshetau (Gorvodokanal). Address: JSC Vodokanal, Karaganda City; Nizhny Bief, Temirtau City; Public Disclosure Authorized Gorvodokanal, Kokshetau City: Contact Person: S.B Uteshov; Deputy Governor of Karaganda; Mr. Erbol Toleuov, Director, Nizhny Bief Ltd.; S.V. Kulagin; Governor of Akmola Oblast, Kokshetau; Tel: 7(3212) 482970; 7(32135) 51644, 62292; 7(32135) 44555; 7(31622) 70963 Fax: 7(3212) 482970; 7(32135) 51644; 7(32135) 44555; +7(31622) 70963 State Committee for Water Resources Address: 28-A Mozhaiskiy Str., 473201, Astana, Kazakhstan Contact Person: Anatoly Ryabtsev, Chairman Public Disclosure Authorized Tel: 7-3172-356727 Fax: 7-3172-356770 Email: [email protected] Ministry of Agriculture Address: Contact Person: A.K. Kurishbayev, Deputy Minister Tel: 7 (3172) 32 37 84 Fax: 7 (3172) 32 39 73 Environment Category F Date PID Prepared February 4, 2003 Auth Appr/Negs Date January 27, 2003 Public Disclosure Authorized Bank Approval Date July 15, 2003 1. Country and Sector Background Water and wastewater services in the urban centers of Kazakhstan are provided by water and wastewater enterprises (vodokanals). In 1993, the central government decentralized the responsibility for the water and wastewater sector to municipalities and phased out operating and capital subsidies to the sector.
    [Show full text]
  • West Kazakhstan Region Supports Small Businesses, Productivity Growth
    -10° / -21°C WEDNESDAY, DECEMBER 5, 2018 No 23 (161) www.astanatimes.com President urges larger role for non- West Kazakhstan region governmental organisations in society supports small businesses, productivity growth enterprise produces various types By Zhanna Shayakhmetova of fuels including diesel fuel of environmental class K5. The ca- ASTANA – The West Kazakh- pacity of the enterprise is 850,000 stan region ranks third in the coun- tonnes per year. The enterprises in try with a 40-percent share of the the field of mechanical engineer- medium-sized enterprises (SMEs) ing, metalworking, construction, in the gross regional product. This and furniture production also make indicator was achieved by increas- a contribution to the industrial ing the number of operating SMEs output. Many of them are export- to 40,000 enterprises with more oriented companies. For example, than 115,000 people working in 95 percent of items produced at the this sector, the region’s Akim Ural Transformer Plant are export- (Governor) Altay Kulginov said oriented,” said Kulginov. in an exclusive interview with the As a result of the industrial pro- newspaper. duction development, labour pro- The oil and gas sector make a ductivity increased by 26 percent. significant contribution to the in- The production in the processing dustrial growth as the region pro- industry grew by 8 percent to 156 duces 45 percent of the natural billion tenge (US$471 million). gas in the country. Karachaganak “Agriculture, especially live- Petroleum Operating B.V. expands stock, has huge potential. The and develops the Karachaganak Kublei company launched the field, one of the world’s largest oil animal waste recycling project and and gas condensate fields.
    [Show full text]
  • KZ Report2018.Pdf
    National Preventive Mechanism for the Prevention of Torture / CONSOLIDATED REPORT • 2016 / 1 CONSOLIDATED REPORT CONSOLIDATED REPORT Prepared by the National Preventive Mechanism Membersconsolidated on report the Preventive Prepared by the National Preventive MechanismVisits members Made on thein 2016Preventive Visits Made in 2017 National Preventive Mechanism for the Prevention of Torture Astana |2018 2017 Consolidated Report of the National Preventive Mechanism members on the preventive visits carried out in 2017, Astana, 2017 - 178 p. The Report has been drafted by the Coordination Council of NPM under the Comissioner for Human Rights and published with the support of the OSCE Programme Office in Astana and the Penal Reform International Representative Office in Central Asia The content of the document is the sole liability of the authors. CONTENTS 1. On some organizational issues of the National Preventive Mechanism in 2017 ............................. 7 2. Rights of convicts in correctional institutions of the Committee of the Criminal Execution System (CCES) under the Ministry of Interior of the Republic of Kazakhstan (MoI RK) .............................15 3. The situation of persons detained in remand centres of the Committee of the Criminal Execution System (CCES) under the Ministry of Interior of the Republic of Kazakhstan (MoI RK) .........................................31 4. The situation of persons held in temporary detention facilities and other institutions of the Ministry of Interior of the Republic of Kazakhstan (MoI RK) .........67 5. The situation of persons held in institutions subordinated to the National Security Committee (NSC) of the Republic of Kazakhstan .............83 6. The situation of persons held in institutions under the Ministry of Defence .............................................89 7.
    [Show full text]
  • Yegorov S Et Al. COVID-19 in Kazakhstan Epidemiological And
    Yegorov S et al. COVID-19 in Kazakhstan Epidemiological and clinical characteristics, and virologic features of COVID-19 patients in Kazakhstan: a nation-wide, retrospective, cohort study. Sergey Yegorov, PhD1*^, Maiya Goremykina, MD2^, Raifa Ivanova, MD2^, Sara V. Good3, PhD, Dmitriy Babenko, MD3^, Alexandr Shevtsov, PhD4 on behalf of the COVID-19 Genomics Research Group#, Kelly S. MacDonald, MD5,6 and Yersin Zhunussov, MD7 on behalf of the Semey COVID-19 Epidemiology Research Group ǁ. SUPPLEMENTARY MATERIAL 1 Yegorov S et al. COVID-19 in Kazakhstan Whole genome sequencing methods Sample collection: Nasopharyngeal swabs were collected from 53 symptomatic patients during clinical assessment. Samples were transported at 4-8C in transport medium (medium 199 with Hanks' salts (Sigma, M0393), 4 ml Gentamicin solution (Sigma, G 1397), 11 ml BSA, fraction V (Sigma, A-8412), 11 ml 1 M HEPES buffer solution (Sigma, 83264) and delivered to the laboratory within 8 hours of collection. SARS-CoV-2 infection validation: A commercially available Real-Time Fluorescent RT-PCR kit (BGI, Shenzhen) was used to confirm SARS-CoV-2-positive samples. For the NGS sequencing, samples were selected up to the 24th PCR threshold cycle. RNA extraction and amplification: Total RNA was isolated using the GeneJet Viral DNA and RNA Purification Kit (Thermo Scientific) and quantified by fluorometry. Reverse transcription was performed with three primer mixes (see Table in appendix p. 3) and SuperScript™ IV Reverse Transcriptase (Invitrogen™) in a 40 μL reaction mixture containing 1х SSIV Buffer, 0,5 mM each dNTP, 5 mM DTT, 100 nM each primer, 10 U/μL SuperScript® IV Reverse Transcriptase and 20 μL RNA.
    [Show full text]
  • CAREC Corridor Implementation Progress, Actions Planned and Support Needs
    CAREC Corridor Implementation Progress, Actions Planned and Support Needs Republic of Kazakhstan Ministry for Investment and Development CONSTRUCTION AND RECONSTRUCTION OF ROADS UNDER NURLY ZHOL Results for 2017 Budget- 316.4 billion tenges Plans for 2018 Length covered – 4.4 thousand km Budget – 269.4 billion tenges Completed– 602 km, including Length covered by works – 4,2 thousand km Center –South – 16 km, Aktau-Schetpe – 170 км, Aktau-Beineu – 60 km; Center – East – 216 km, Almaty-Taldykorgan - 24, Completed – 528 km, including Aktobe-Makat – 26 km, Uralsk-Kamenka– 65 km, Astana-Petropavlovsk – 5 km, Kordai bypass road – 21 km; 1 CONSTRUCTION AND RECONSTRUCTION OF ROADS IN 2018 Budget – 269.4 billion tenges; 1, Temirtau-Karaganda–61 km Length covered by works – 4.2 thousand km; Including Kargandabypass, toll road Completed – 528 km. Cost – 64 billion tenges, Budget 2018 – 13,8 billion tenges. Implementation period: 2017-2020 2. South-West Astana bypass road – 33 km Cost – 60.2 billion tenges. Budget 2018 – 26,8 billion tenges. Implementation period: 2017-2019 3. Astana-Pavlodar-Semei – Kalbatau – 914 km Cost – 305 billion tenges. Budget 2018 – 48 billion tenges, Implementation period: 2010-2019 4. Astana-Petropavlovsk-RF border – 61 km Including access road to Kokshetau Cost – 44,2 billion tenges. Budget 2018 – 12,9 billion tenges, Completed в 2019 5. Щучинск-Зеренда – 80 km Cost – 15,2 billion tenges, Budget 2018 – 3,3 billion tenges. Implementation period: 2017-2019 6. Kostanai-Denisovka – 114 km Cost – 36,2 billion tenges. Budget 2018 - 3,5 billion tenges. Implementation period: 2017-2020 7. Aktobe-Makat – 458 km Cost – 178,9 billion tenges ( Budget 2018 - 51,3 billion tenges,.
    [Show full text]
  • Enterprises and Organizations – Partners of the Faculty
    ENTERPRISES AND ORGANIZATIONS – PARTNERS OF THE FACULTY 1. JSC "Agrofirma- Aktyk" 010017, Akmola region, Tselinograd district, village Vozdvizhenka 2. The Committee on Forestry and Hunting 010000, Astana, st. Orynbor, 8, 5 entrance of the Ministry of Agriculture of the Republic of Kazakhstan 3. The Water Resources Committee 010000, Astana, Valikhanov Street, Building 43 4. RSE "Phytosanitary" the Ministry of 010000, Astana, Pushkin Street 166 Agriculture 5. LLP "SMCCC (center of Science and 010000, Akmola region, Shortandy District, Nauchnyi manufacture of Crop cultivation) named village, Kirov Street 58 after A.I. Barayev" 6. Republican Scientific methodical center 010000, Akmola region, Shortandy District, Nauchnyi of agrochemical service of the Ministry village, Kirov Street 58 of Agriculture 7. State Republican Centre for 010000, Astana, st. Orynbor, 8, 5 entrance phytosanitary diagnostics and forecasts the Ministry of Agriculture 8. RSE "Zhasyl Aimak" 010000, Astana, Tereshkova street 22/1 9. State Institution "Training and 010000, Akmola region, Sandyktau District, the village Production Sandyktau forestry" of Hutorok 10. LLP "Farmer 2002" 010000, Akmola region, Astrakhan district 11. "Astana Zelenstroy" 010000, Astana, Industrial Zone, 1 12. ASU to protect forests and wildlife 010000, Akmola region, Akkol district, Forestry village "Akkol" 13. State Scientific and Production Center 010000, Astana, Zheltoksan street, 25 of Land Management," the Ministry of Agriculture 14. State Institution "Burabay" 021708, Akmola region, Burabay village, Kenesary str., 45 15. "Kazakh Scientific and Research 021700, Akmola region, Burabay district, Schuchinsk Institute of Forestry" city, Kirov st., 58 16. LLP "Kazakh Research Institute of Soil 050060, Almaty, Al-Farabi Avenue 75в Science and Agrochemistry named after U.Uspanova" 17.
    [Show full text]
  • Resettlement of Kazakhs in China in the 20-30S of the XX Century
    Utopía y Praxis Latinoamericana ISSN: 1315-5216 ISSN: 2477-9555 [email protected] Universidad del Zulia Venezuela Resettlement of Kazakhs in China in the 20-30s of The XX Century MEIR YESKENDIROV, MEIR; TOKISHKADYROV, BOTABEK; BAYSSARINA, KYMBAT; IBRAYEMOVA, MAIRA Resettlement of Kazakhs in China in the 20-30s of The XX Century Utopía y Praxis Latinoamericana, vol. 25, no. Esp.10, 2020 Universidad del Zulia, Venezuela Available in: https://www.redalyc.org/articulo.oa?id=27964799044 DOI: https://doi.org/10.5281/zenodo.4155765 This work is licensed under Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International. PDF generated from XML JATS4R by Redalyc Project academic non-profit, developed under the open access initiative Utopía y Praxis Latinoamericana, 2020, vol. 25, no. Esp.10, Noviembre, ISSN: 1315-5216 2477-9555 Artículos Resettlement of Kazakhs in China in the 20-30s of e XX Century Reasentamiento de kazajos en China en los años 20-30 del siglo XX MEIR MEIR YESKENDIROV DOI: https://doi.org/10.5281/zenodo.4155765 Shakarim University of Semey, Kazajistán Redalyc: https://www.redalyc.org/articulo.oa? [email protected] id=27964799044 http://orcid.org/0000-0001-7211-6342 BOTABEK TOKISHKADYROV Shakarim University of Semey, Kazajistán [email protected] http://orcid.org/0000-0001-7402-1590 KYMBAT BAYSSARINA Shakarim University of Semey, Kazajistán [email protected] http://orcid.org/0000-0003-1711-8294 MAIRA IBRAYEMOVA Shakarim University of Semey, Kazajistán [email protected] http://orcid.org/0000-0002-6776-5505 Received: 28 August 2020 Accepted: 29 October 2020 Abstract: is article describes the historical aspects of the resettlement of Kazakhs from eastern Kazakhstan in China.
    [Show full text]
  • Kazakhstan: Trade Facilitation and Logistics Development Strategy Report
    Kazakhstan: Trade Facilitation and Logistics Development Strategy Report The Asian Development Bank has been supporting efforts to reduce poverty and improve livelihoods in the Central Asia Regional Economic Cooperation (CAREC) countries. A major focus of these efforts is improving the transport and trade sectors to spur economic growth and promote social and political cohesion within the region. Improving the efficiency of the CAREC transport corridors will allow these landlocked countries to take full advantage of being transit countries between the surging and dynamic economies of the East and the West. This report, one of a series of nine reports, highlights the substantial challenges that Kazakhstan needs to overcome and recommends measures to make its transport and trade Kazakhstan sectors more efficient and cost-competitive. Trade Facilitation and Logistics Development About the Asian Development Bank Strategy Report ADB’s vision is an Asia and Pacific region free of poverty. Its mission is to help its developing member countries substantially reduce poverty and improve the quality of life of their people. Despite the region’s many successes, it remains home to two-thirds of the world’s poor: 1.8 billion people who live on less than $2 a day, with 903 million struggling on less than $1.25 a day. ADB is committed to reducing poverty through inclusive economic growth, environmentally sustainable growth, and regional integration. Based in Manila, ADB is owned by 67 members, including 48 from the region. Its main instruments for helping its developing member countries are policy dialogue, loans, equity investments, guarantees, grants, and technical assistance. Asian Development Bank 6 ADB Avenue, Mandaluyong City 1550 Metro Manila, Philippines www.adb.org ISBN 978-971-561-812-0 Publication Stock No.
    [Show full text]
  • List of Organizations in Kazakhstan with Validated PIC
    List of Organizations in Kazakhstan with Validated PIC # City Legal Name HEI PIC 1. Aktau Caspian State University of Technologies and Engineering Named after Sh. Yessenov HEI 933536052 2. Aktobe West Kazakhstan Marat Ospanov State Medical University HEI 948965357 3. Almaty Kazakh Ablai Khan University of International Relations and World Languages HEI 935170017 4. Almaty Al-Farabi Kazakh National University HEI 959424479 5. Almaty Almaty University of Power Engineering and Communications HEI 934119410 6. Almaty Almaty Management University HEI 937194601 7. Almaty Almaty Technological University HEI 927615366 8. Almaty Central Asia Institute for Strategic Studies 916839636 9. Almaty Asfendiyarov Kazakh National Medical University HEI 925625314 10. Almaty Association Education for All in Kazakhstan 942793732 11. Almaty Caspian Public University HEI 934631182 12. Almaty Center of Business Information, Social and Marketing Researches Bisam-Central Asia 953692458 13. Almaty Central Scientific Library of Ministry of Education and Science of Kazakhstan 997262530 14. Almaty Ciom Ltd 997837546 15. Almaty City Scientific-Methodical Centre of New Technologies in Education 921533369 16. Almaty Echo Association 915666324 17. Almaty Ecoservice-S Llp 959148417 18. Almaty Eurasian Technological University HEI 916959431 19. Almaty Independent Experts Consulting Board to Promote Scientific Research Activity in Kazakhstan 999536016 20. Almaty Institute of Combustion Problems Scientific Committee of the Ministry of Education and Science of the Republic of 940482028 Kazakhstan 21. Almaty Institute of Geography 998043574 22. Almaty Institute of Ionosphere, Ministry of Education and Science 999628554 23. Almaty Institute of Polymer Materials and technology 906791794 24. Almaty International Educational Corporation HEI 935074472 25. Almaty International University of Information Technologies HEI 942379542 26.
    [Show full text]
  • KAZAKHSTAN Development of Six New Hospitals HEALTHCARE
    OFFICIAL USE KAZAKHSTAN Development of six new hospitals HEALTHCARE PLANNING ADVISORY SERVICES TO THE MINISTRY OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN TERMS OF REFERENCE 1. BACKGROUND The Ministry of Health of the Republic of Kazakhstan (the “MoH”) is developing a new Hospitals Modernisation Programme (“State Programme”), which envisages the construction of up to 19 new hospitals to replace 40 outdated existing facilities and the upgrade of up to 50% of the hospital bed capacity in Kazakhstan. Hospital projects under the State Programme will follow the facility management model and will be procured as Public Private Partnerships (“PPP”) or utilise the Design, Build, Operate and Maintain (“DBOM”) approach. The purpose of this healthcare planning consultancy assignment is the development of comprehensive hospital healthcare needs assessments and hospital functional specifications for 6 of these new hospitals. The hospitals included in this initial first phase of the programme are as follows: No. Location Estimated bed numbers 1 Kyzylorda (DBOM) 500 2 Kokshetau (PPP) 630 3 Kostanai (PPP) 500 4 Taraz (PPP) 500 5 Pavlodar (PPP) 500 6 Atyrau (PPP) 500 Bed numbers presented above are broad estimates only at this stage as this Consultancy assignment is intended to develop accurate bed numbers for each hospital. 2. OBJECTIVES The objective of this assignment is the development of comprehensive hospital healthcare needs assessments and hospital functional specifications for 6 of these new hospitals. The healthcare services to be provided in these hospitals will be delivered by the Kazakhstan Ministry of Health (MoH). Consequently, once completed, the hospital functional specifications will be owned by, and the responsibility of, the MoH.
    [Show full text]
  • KAZAKHSTAN - Review of Grain Storage and Transportation Infrastructure Issues
    KAZAKHSTAN - Review of Grain Storage and Transportation Infrastructure Issues CONTENTS Abbreviations & Acronyms ............................................................................................................ 5 Executive summary ......................................................................................................................... 3 1. Grain Storage Challenges and Opportunities .......................................................................... 6 1.1. Regulatory Framework ..................................................................................................... 6 1.2. Storage Services ............................................................................................................. 10 1.3. Storage Capacity ............................................................................................................ 11 1.4. Drying Capacity ............................................................................................................. 15 1.5. Storage Management ...................................................................................................... 16 2. Transportation Infrastructure Challenges and Opportunities ................................................ 20 2.1. Railway Transportation .................................................................................................. 20 2.2. Road Transportation ....................................................................................................... 24 3. Conclusions and Policy Recommendations
    [Show full text]
  • Kazakhstan Systematic Country Diagnostic
    Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Report No. 125611-KZ A new growth model for building a secure middle class Kazakhstan Systematic Country Diagnostic April 2018 Contents Acknowledgments .......................................................................................................................... viii Abbreviations .................................................................................................................................... x 1. Setting the stage: Poverty, shared prosperity, and jobs in a changing economic context .................. 1 1.1 Trends in poverty reduction and shared prosperity ........................................................................... 4 1.2 Jobs, earnings, and productivity ........................................................................................................ 13 1.3 Looking ahead—four mutually reinforcing strategic pillars for building a secure middle class ....... 18 2. Strategic Pillar 1: Economic management for diversification ......................................................... 21 2.1 Understanding the components of economic growth in Kazakhstan ............................................... 21 2.2 Fiscal and monetary policy during commodity cycles ....................................................................... 26 2.3 Governance and public sector effectiveness ...................................................................................
    [Show full text]